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Benefit coverage

Members of IBEW Local 353 enjoy one of the most comprehensive health and dental benefit plans anywhere.

Register and sign up to receive email alerts about your benefit plan. Active member coverage includes:

Accident insurance

When accidents happen, it’s good to know that you and your family have the extra
protection of accident insurance which pays a benefit if you’re injured or die because
of an accident, on or off the job. Payments are tax-free and are paid in addition to
any other insurance you may have.

You, your eligible spouse and eligible children are covered for the amounts shown
below if death or permanent injury occurs within 90 days of an accident. Accident
insurance covers you and your family for the following amounts:

$25,000 for member
$10,000 for spouse
$2,500 for each child

If you die in an accident, your spouse and child continue to receive accident insurance
for 12 months at no cost.

Other accident benefits (Conditions apply, contact TEIBAS for details).

In addition to cash payouts, IBEW Local 353’s accident insurance may also help to
cover the following costs:

Daycare if you die in an accident, for children under age 12
Transportation for a family member to visit a beneficiary who is hospitalized more than 150 kilometers from home
Home and vehicle alteration for wheelchair accessibility
Rehabilitation for special training required as a result of injuries
Return home for preparing and shipping a body back to the city of residence
If more than 150 km away, and spouse occupational training if you die in an accident.

What’s not covered

Member and family accident insurance doesn’t cover:

Any form of disease, illness or physical or mental infirmity, or
Bacterial infections (except pyogenic (producing pus) infections related to an accidental cut or wound).

Best Doctors 1-877-419-2378

Best Doctors Canada (www.bestdoctorscanada.com) provides a comprehensive medical review that addresses three key questions: Is my diagnosis correct? What’s the best treatment? What’s going to happen to me? According to the benefit provider, the answers may help to reduce complications, avoid invasive treatment and help to bring about a better outcome. How successful is the service? After more than 20,000 medical reviews, Best Doctors found that one in five cases the initial diagnosis needed to be changed, while three in five cases suggested alternative treatment.

Best Doctors is available to age 65. It doesn’t provide medical reviews that require a physical examination, such as chronic pain and soft-tissue injuries (e.g. carpal tunnel syndrome and repetitive stress injury) or psychiatric conditions.

Dental

Our dental plan is a key feature of IBEW Local 353’s benefit package and accounts for about a third of total plan costs. It pays 100% of the cost of many dental treatments and provides partial payment for others. The plan uses the current year’s Ontario Dental Association fee guide for general practitioners.

Dental work as a result of an accident

Dental treatment resulting from an accident may not be covered under your dental plan. However, it may be fully covered under your health plan if treatment is completed within six months of the accident (excluding motor vehicle or workplace accidents). Contact Great-West Life if you’re not sure where to submit your claim.

Anticipating a big dental bill? Make sure you’re covered

When it comes to dental treatment, no one likes surprises. If you or a family member need dental treatment costing more than $300, ask your dentist to prepare a treatment plan before any work begins.

The plan pays for a great number of dental services, but it doesn’t cover everything listed in the Ontario Dental Association’s fee guide for general practitioners. If you or your dentist are unsure if a service is covered, contact Great-West Life and refer to plan #51189.

Treatments

Coverage

Diagnostic services including: Examinations and x-rays 100%

Preventive services including: Cleaning, polishing, fluoride treatment, oral hygiene instruction, root planin 100%

Restorative and surgical services (minor) including: Fillings (amalgam and tooth – coloured), stainless steel crowns, extractions and other basic oral surgery 100%

Restorative services (major) including: Inlays, onlays and crowns 50%

Endodontic services including: Root canals, removal of tooth nerve 100%

Periodontic services including: Periodontal surgery and bite adjustment 75%

Removable prosthodontics including: New dentures, denture repair, relining, rebasing and replacemen 100%

Fixed prosthodontics including: New bridges, bridge repair and replacement 50%

Orthodontic treatment for children ages 6-18 when treatment begins: Lifetime maximum of $2,000 per child 75%

Recall limits

Standard or periodontal recall examination of a previous patient, as well as preventive recall packages are limited to once in any calendar year for adults and twice in any calendar year for children under 19.

What’s not covered

In general, the dental plan will not pay for:

Athletic mouth appliances
Cosmetic treatment, such as treatment performed to cover discoloured enamel, close spaces between teeth or reshape malformed teeth (as determined by Great-West Life)
Lab fees that exceed reasonable and customary charges
Fluoride treatments for covered person age 19 and over
Replacing an existing appliance that was lost or stolen
Services and supplies for full mouth reconstruction, correcting vertical dimension or correcting temporomandibular joint dysfunction
Specialist fees.

Disability

When you can’t work because of illness or injury, it’s important to know that you’ll still have some money coming in. You may qualify for short-term disability benefits for up to 26 weeks and long-term disability benefits thereafter.

Eligibility

You qualify for short-term disability benefits if you have worked within 31 days of the disability or within 91 days of hospitalization and you have earned:

At least 100 bank hours in the 91 days just before the day your disability begins (including periods between different disabilities), or
100 bank hours in the previous 180 days if you are a hospital in-patient or surgical outpatient.

You receive benefits if you are totally disabled and can’t work at your own job because you are sick, injured or participating in an approved substance abuse program. Medical proof is required to back up your claim. Your benefits are reduced by any amount paid to you by the Workplace Safety and Insurance Board (WSIB) and the CPP/QPP for the same disability.

Your short-term disability benefit is:

Equal to 75% of basic weekly earnings, up to $600 per week
Payable for up to 26 weeks

Under income tax law, short-term disability benefits are treated as taxable income. Great-West Life will deduct taxes before paying you your benefit.

What’s not covered

Short-term disability benefits are not paid for injuries resulting from a motor vehicle accident. They are also not paid for any period in which you receive direct payments from your employer (unless it is received during an approved period of rehabilitative employment), or do not participate or cooperate in a reasonable and approved treatment program.

To qualify for benefits, you must:

Not be receiving an IBEW Local 353 pension
Not be working, except as part of a rehabilitation program that has been approved under the plan
Not be incarcerated in a prison or similar institution
Not be on parental or maternity leave, unless disabled as a direct result of the pregnancy.

Waiting period

When applying for disability, the sooner you notify the union office and submit your completed claim form, the sooner your disability claim can be assessed. The deadline
for applying is 90 days from the date of the injury or illness.

Your benefit is paid:

From the first day if you are a hospital in-patient or an out-patient requiring day surgery (excluding diagnostic or exploratory procedures that don’t require general anaesthesia)
From the first day after you have been treated by a doctor or chiropractor if you are totally disabled within 30 days due to an accidental injury, or
From the eighth day after you have been treated by a doctor or chiropractor if you are absent from work because of sickness.

The first or eighth day is counted from the later of your last day at work, or the date of the doctor’s visit.

If you return to work and become disabled again within two weeks, there is no waiting period unless your new illness or injury is unrelated to your previous condition. If your coverage ends, or if you are unemployed for any reason and you still meet the requirement for 100 accumulated hours, your short-term disability coverage continues for 31 days after your last day at work, or for 91 days after your last day at work if you are a hospital patient.

Physician’s care

Short-term disability benefits are paid only while you are under the care of an appropriate medical practitioner and receiving care appropriate for your condition. In some circumstances you may be required to see a specialist. If you stop seeing a medical practitioner, your benefits will stop. If substance abuse contributes to your disability, you must participate in a recognized substance abuse program.

Chiropractor’s care

If you are being treated by a chiropractor instead of a doctor, benefits can be paid for a maximum of four weeks.

Rehabilitation

Your disability case manager from Great-West Life will assess your need for rehabilitation
and put you in touch with the right internal experts to help you get well. In consultation with your doctor, Great-West Life may put together a program of treatment or activities to help you get in shape for work. You must participate in order to continue receiving your benefit payments.

Workplace Safety and Insurance Board (WSIB) and CPP/QPP benefits

If you are disabled because of an accident at work, you must apply for WSIB benefits. You may also be required by the Great-West Life case manager to apply for CPP/QPP benefits. Any disability benefits you receive from this plan are reduced by any CPP/QPP or WSIB benefits you receive for the same disability. This ensures that IBEW Local 353 plan covers what’s not already covered by WSIB and CPP/QPP benefits.

Before any disability benefits begin, you must complete assignment of benefits or authorization forms required by Great-West Life. This allows the plan to communicate with CPP/QPP or WSIB and recover any overpayments of disability benefits.

If you are receiving disability benefits and the WSIB or CPP/QPP later pays benefits for the same illness or injury, you must repay the IBEW Local 353 plan for the disability benefits you have already received.

When you are injured at work, you should always apply for short-term disability benefits in the event your WSIB claim is rejected. This will ensure that you meet the notice and proof deadlines for submission of claims. You must also let the union office know if you are applying for WSIB benefits so that the union office can notify the insurance company and TEIBAS.

Continuing disability benefits

After the 26-week short-term disability coverage ends, you may be assessed for long-term disability benefits. Your long-term disability benefit is 75% of your pre-disability earnings up to a maximum benefit of $3,300 per month. Under income tax law, long-term disability benefits are treated as taxable income. Great-West Life must deduct tax before paying your benefit.

What totally disabled means

You are considered totally disabled if you have an illness or injury which prevents you from performing the essential duties of your own job during the qualifying period (26 weeks) and the next twenty-four months. After that, you are totally disabled only if, due to illness or injury, you are unable to perform the duties of any occupation for which you are or may become reasonably qualified by education, training and experience.

Proof of disability

From time to time, you will be asked by Great-West Life to provide medical proof of your disability. Great-West Life may also need to assess how well you are able to function and whether you require retraining. This may involve seeing a specialist for your condition or taking tests to measure job skills or your ability to perform physical tasks. You must cooperate with Great-West Life on these requests in order to continue receiving your benefits.

Duration of Long-term disability benefits

Benefits are paid for as long as you remain totally disabled to age 62 or you retire, whichever comes first. If you qualified for long-term disability benefits before January 1, 1995, your benefits are paid to age 65.

Reductions in Long-term disability (offsets)

Your IBEW Local 353 long-term disability benefit is reduced by:

Any WSIB benefits you receive for the same period of disability, excluding indexing adjustments
Any benefit received for the same disability from the CPP/QPP or other government programs, excluding indexing adjustments and dependents’ benefits, and
Any pension from the IBEW Local 353
Any benefit from the IBEW International benefit fund.

If you are receiving income benefits (other than the direct offsets described above), your IBEW Local 353 long-term disability payment combined with these other benefits must not equal more than 85 per cent of your monthly pre-disability earnings.

If it does, your long-term disability payment will be reduced by the excess. Other benefits that are counted under this 85-per-cent-all sources maximum include:

Direct offset amounts (CPP/QPP and WSIB)
Any benefit received for an unrelated disability from the CPP/QPP or other government program, excluding indexing adjustments and dependents’ benefits
Benefits from another group insurance plan.

Rehabilitative employment

If you are disabled and receiving long-term disability benefits, you may be able to perform
some kind of rehabilitative employment, part-time work or retraining activities. This may help you get back to full-time employment. Any rehabilitative employment or activity, whether paid or unpaid, must be approved by your doctor, Great-West Life and the Trustees.

If your total monthly income from the following three sources is more than your basic monthly earnings before you became disabled, your long-term disability benefits will be reduced by the excess amount:

Your long-term disability benefits
Your income from rehabilitative employment, and
Any amounts that are offsets.

If you continue to earn income from rehabilitative employment more than 24 months after
the end of your period of short-term disability, your long-term disability benefits will stop.

Coverage while on short-term, long-term or WSIB benefits

Your coverage under the IBEW Local 353 benefit plan continues at no cost to you as long as you are receiving short-term disability, long-term disability from the plan or full WSIB benefits. If you’re approved for WSIB, the plan will provide benefit coverage during the first 12 months from the date of the disability, regardless of your contnued membership in IBEW Local 353. After the 12 months of WSIB benefits, the plan can terminate coverage if membership in the union is not maintained. If you are receiving workers’ compensation benefits from outside Ontario, you may submit a request for coverage to the Trustees.

Special disability pension credits

If you are disabled because of an illness or accident, you may qualify for special disability pension credits. These credits work much the same way as regular pension contributions and are used to increase your overall retirement pension. Special disability pension credits are based on proof of disability.

Generally speaking, you qualify for special disability credits if one or more of the following applies:

You are receiving long-term disability benefits under the IBEW Local 353 group benefits plan
You are not working because of an illness or injury for which you are receiving full benefits from the Workplace Safety and Insurance Board (WSIB)
You are receiving a disability pension from both the WSIB and the Canada Pension Plan
You have been disabled for more than six months due to a motor vehicle accident for which you are receiving no-fault insurance disability income benefits.

You are given 150 hours of special disability credits for each month of disability (prorated for partial months). These credits are used only to increase your pension at retirement. If you leave the plan or die before retirement, any part of your pension that is based on special disability credits will not be paid (except where those credits were received during the first 12 months after an injury for which you were receiving WSIB benefits).

You are ineligible for pension credits after the earliest of:

The date your pension starts under this plan, or
The date you are eligible for an unreduced pension (except during the first 12 months you are receiving full WSIB benefits).

Life insurance

You are covered for $25,000 life insurance. This is paid tax free to your named
beneficiary or to your estate. Pensioners receive $10,000 if covered under one of
the retiree plans. This is paid tax free and may be taken by your beneficiary as a
one-time payment or in installments.

This benefit applies to your life only. No life insurance will be paid on the death
of your spouse or child.

Shortened life expectancy and life insurance

If you have a terminal illness with less than one year to live, you may request an
advance life insurance payment of $12,500 (this option is not available under retiree
death benefits). This will be deducted from the payment upon your death. Contact
TEIBAS for more information on this benefit.

Taxes on life insurance

Life insurance benefits are received tax free by your beneficiary. Under income tax
law, employer contributions for life insurance are taxed as income. The exact amount
is shown on the T4A form that you receive every year.

Naming a beneficiary for accident and life insurance

When you first join the plan, you must complete an application form where space
is provided to name your life insurance and accident insurance beneficiary(ies). You
may name anyone you wish as your beneficiary and you may name more than one
person. If you name more than one person, your death benefit will be divided equally
unless you provide other instructions.

Any death benefit will be paid to the most recently named beneficiary on file with TEIBAS unless you have a more recent will that makes specific reference to your life insurance or your personal accident insurance.

If you don’t name a beneficiary

If you don’t name a beneficiary, death benefits will be paid to your estate and may
be subject to probate fees, estate taxes and creditor claims.

Changing your beneficiary

You can change your beneficiary at any time by completing a new form available
from TEIBAS.

Naming a child as your beneficiary

If your beneficiary is a minor, you should consider appointing a trustee to look after
your child’s benefits. Otherwise, your death benefits may be held in trust until your
child reaches age 18.

Medical supplies and services

Expenses for the following are covered:

Acupuncture (licensed) to $500 per calendar year
Ambulance transportation (must provide proof of medical emergency requiring professional ambulance services, does NOT include ambulance from hospital to home)
Artificial limbs and eyes (combined with the Ontario Assistive Devices Program)
Blood glucose monitoring machines (glucometers) and related supplies for use by people with diabetes
Blood transfusions, including cost of blood
Braces prescribed by a chiropractor, physiotherapist or physician (must be made of rigid material)
Casts
CaverMap (or similar device for use in prostate surgery) disposable parts and supplies
Chiropractic visits to $500 per calendar year
Christian Science practitioner to $500 per calendar year (must be listed in the current Christian Science Journal)
Compression hose (with a compression factor of 20mmHg or higher)
Crutches
Dental treatment performed outside hospital by a dentist or oral surgeon for accidental injury to natural teeth (within six months of accident)
Homeopath (licensed) to $500 per calendar year, does not include homeopathic preparations
Hospital bed (rental or purchase, if approved)
Massage therapist (registered) to $500 per calendar year
Naturopath (licensed) up to $80 per hour and $500 per calendar year
Nursing services provided in patient’s home when required for medical reasons, including registered graduate nurses, licensed practical nurses or registered nursing assistants depending on the level of expertise required, excluding nurses who are family members ($10,000 per calendar year, must request special form from Great-West Life and have it completed by the doctor who is treating you)
Orthopaedics to a combined maximum of $500 in any 12-month period, including: orthopaedic shoes and special foot appliances, prescribed by a physician or surgeon; custom-made and specifically designed and moulded to protect or restore the function of a limb or limbs to compensate for limitations or to increase physiological performance; orthotics, lifts or wedges prescribed by a podiatrist, chiropodist, chiropractor, orthopaedic surgeon or physician and custom-made of either plastic or steel, but not including leather or cork orthotics, sport orthotics or fashion orthotics; Synovial fluids injections
Osteopath or podiatrist (licensed) to $500 per practitioner per calendar year
Oxygen and its administration
Physiotherapist (licensed) to $500 per calendar year
Sleep apnea appliances and equipment to $500 every five years (after Ontario Assistive Devices Program)
Splints trusses, or wheelchair (rental or purchase, if approved).

Member Assistance Program 1-800-387-4765

The Member Assistance Program is best known for providing confidential, short-term counseling and indeed more than two-thirds of the services they provide are to help people in crisis. But the Member Assistance Program benefits are broader. The literature by the service provider Shepell.fgi promotes the Member Assistance Program as a way for individuals to “feel better, solve problems and prevent future problems.”

The list of services available to you and your dependents is long and varied. The services range from relationship and family issues, such as divorce and separation or concerns about aging parents, to nutritional information to help deal with weight management, high blood pressure, diabetes and heart disease. Other services include tackling addictions, dealing with grief, depression, workplace conflict and personal bankruptcy. If you’re not sure if the Member Assistance Program service can help you, give them a call.

Prescription drugs

Your drug plan provides you with affordable access to most of the prescription drugs
available today. It’s one of the most valuable parts of your benefits plan.

The IBEW Local 353 plan is a drug-card plan. This means you don’t have to make
a written claim on a claim form if you use your drug card, which is accepted at most
pharmacies in Canada.

You can still submit claims to Great-West Life for prescription drugs using paper forms. If your card is lost or misplaced, notify TEIBAS immediately.

When the card is used by your pharmacist, the system electronically identifies:

Covered family members
The plan’s dispensing fee maximum of $6.50
100% payment on eligible generic and brand name drugs, plan restrictions, including notification of any pre-authorization requirements.

Taking medication on a regular basis?
You can also use your drug card with a mail-order pharmacy. Mail-order pharmacies
provide free home delivery of your prescription drugs (within two to three days), and
in some cases lower dispensing fees and drug ingredient costs than regular pharmacies. Ask about discounts for a 90-day supply of drugs at a time.

When you’re 65 and older
At age 65 drug coverage under the IBEW Local 353 plan changes depending on whether you’re collecting an IBEW Local 353 pension.

What’s covered under the IBEW Local 353 drug plan?
Your drug plan covers most prescription drugs as prescribed and we encourage generic drug substitution where possible as a way of controlling costs. Specialized or new drugs may require pre-approval by Equitus Consulting, an independent specialist that helps the plan manage prescription drugs and the use of medical equipment and appliances.

Drugs not covered include

Any drugs or items which do not have a Drug Identification Number (DIN)
Erectile dysfunction drugs
Smoking cessation products
Over-the-counter medications such as cold remedies, laxatives or antacids
Vaccines and immunization products
Vitamins

Drugs that require pre-approval
We’re committed to effectively managing our drug plan while ensuring you and your family receive the care they need. Equitus Consulting is an independent specialist that helps us manage drugs that require special attention because they are either new, extremely expensive (some new drugs cost $20,000 annually or more), or because there may be other effective treatments available.

Drug pre-approval process
If the drug prescribed for you requires pre-approval, please follow these steps:

Call 1-866-401-8323 to contact Equitus and request a pre-authorization form. You will need to tell them that you are a member of IBEW Local 353 and give them the name of the drug.
Ask your doctor to complete the form and return it to you, or to send it directly to Equitus in the envelope provided. (Please remember that our plan doesn’t cover the cost of completing this medical form.)
After review and any necessary consultation with your doctor, the medical reviewer at Equitus will notify you whether the drug has been approved or not. Equitus’ medical reviewers are doctors who have been certified by the Medical Review Officer Certification Council.
If there is a dispute, it will be resolved between the medical reviewer and your doctor. Great-West Life, TEIBAS and the Trustees will be informed of the decision.

If you have any questions about pre-approval, please contact Equitus.

The following is the list of drugs requiring pre-approval:

Actemra (for rheumatoid arthritis)
Adcirca (for pulmonary arterial hypertension (PAH))
Afinitor (for renal cancer)
Alimto (for lung cancer)
Amevive (for severe psoriasis)
Aptivus (for HIV/AIDS)
Atriance (for T-cell acute lymphoblastic leukemia)
Atripla (for HIV)
Avastin (for colo-rectal cancer)
Baraclude (for hepatitis B)
Cayston (for cystic fibrosis)
Celsentri (for HIV)
Cerezyme (for Gaucher’s disease)
Cimzia (for rheumatoid arthritis)
Clolar (for acute pediatric lymphoblastic leukemia)
Duodopa (for Parkinson's Disease)
Elaprase (for Mucopolysaccharidosis II or Hunter Syndrome)
Emtriva (for HIV/AIDS)
Enbrel (for rheumatoid arthritis)
Erbitux (for colo-rectal cancer)
Fabrazyme (for Fabry’s disease)
Firmagon (for advanced prostate cancer)
Fludara (for chronic lymphocytic leukemia)
Forteo (for osteoporosis)
Gemzar (for metastatic breast cancer)
Gleevec (for chronic myelogenous leukemia)
Hepsera (for hepatitis B)
Humira (for rheumatoid arthritis)
Ilaris (for cryopyrin-associated periodic syndrome (CAPS)
Iressa (for lung cancer)
Isentress (for HIV)
Kineret (for rheumatoid arthritis)
Kuvan (for phenylketonuria PKU)
Lucentis (for age-related macular degeneration)
MabCampath (for leukemia)
Macugen (for macular degeneration)
Meridia (for anti-obesity)
Myozyme (for Pompe disease)
Nplate (for adult chronic idiopathic thrombocytopenic purpura, or ITP)
Omnitrope (growth hormone to treat conditions in children and adults)
Orencia (for rheumatoid arthritis)
Pegasys RBV (for hepatitis C)

Pegetron (for hepatitis C)
Posanol (for invasive fungal infections)
Prezista (for HIV)
Raptiva (for severe psoriasis)
Remicade (for rheumatoid arthritis and Crohn’s disease)
Remodulin (for pulmonary arterial hypertension)
Replagal (for Fabry’s disease)
Revatio (for pulmonary arterial hypertension)
Reyataz (for HIV/AIDS)
Rituxan (for non-Hodgkin's lymphoma)
Sativex (for pain caused by MS)
Sebivo (for hepatitis B)
Sensipar (for hyper-thyroidism)
Simponi (for rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis)
Soliris (for paroxysmal nocturnal hemoglobinuria (PNH))
Somavert (for acromegaly - excess hormone growth)
Sprycel (for chronic myelogenous leukemia)
Stelara (for psoriasis)
Sutent (for gastrointestinal stromal tumors)
Tarceva (for non small-cell lung cancer)
Tasigna (for chronic myeloid leukemia)
Telzir (for HIV/AIDS)
Tenuate (for anti-obesity)
Thelin (for pulmonary arterial hypertension)
Tygacil (for serious bacterial infections)
Tykerb (for advanced breast cancer)
Tysabri (for multiple sclerosis)
Vectibix (for colorectal cancer)
Velcade (for multiple myeloma)
Victoza (for type 2 diabetes)
Volibris (for primary arterial hypertension)
Xenical (for anti-obesity)
Xolair (for asthma)
Xyrem (for cataplexy in patients with narcolepsy)
Zemplar (for chronic kidney failure)
Zevalin (for non-Hodgkin's lymphoma).

Travel medical emergency insurance 1-866-870-1898

Your IBEW Local 353 travel plan provides three types of coverage:

Medical emergency benefits including emergency health care expenses while traveling outside the province, such as hospital accommodation, doctor’s charges, diagnostic services, paramedical services, prescriptions, etc.
Non-medical benefits such as flying a friend or family member to your bedside, meals and accommodation, returning a deceased family member to Canada, etc.
Other emergency services such as helping you find a doctor or hospital, translation services, emergency evacuation, direct billing, transmission of urgent messages to family and business partners, etc.

The travel medical emergency insurance and assistance plan covers a wide range
of medical emergencies, but it doesn’t cover everything. When it comes to medical
insurance it’s better to be safe than sorry—so know what’s covered and what’s not.
Before heading out on a trip, be sure to review the Viator Out of Province/Canada
Travel Medical Emergency booklet.

Effective May 1st - New rules for travelling to Cuba

Don’t travel without your travel assistance, OHIP cards

Your Viator travel assistance card is the key to your coverage under the travel plan. It provides the toll-free numbers for the Global Excel assistance centre and gives you important information such as your group policy number. Calls to Global Excel are answered 24-hours a day, seven days a week.

You will be asked for your OHIP number if you call Global Excel when traveling. For this reason, it is very important for you and any family members traveling with you to carry your OHIP numbers.

Trip limit

Your travel plan covers each trip for up to 60 days and $5,000,000 per person. If
you’ve been away for 60 days, you must return home for at least 24 hours before
starting your next trip, otherwise your coverage will stop.

Extensions over the 60-days

There are a few situations in which the 60-day period is automatically extended for
up to 72 hours. For example:

If you are traveling by car and it breaks down, or a late plane, train, etc. makes you miss your scheduled return home
If your doctor orders you to delay your departure because of a covered medical emergency, or
If you’re in the hospital when your 60-day limit is up (coverage is extended after your release from the hospital).

Proof of travel

There’s no need to notify anyone when you leave or return to Ontario. But, if you
file a claim, you will need to show proof of your departure and return dates. This could
be a hotel or airline receipt, or even proof of purchase from a store or gas station.

Coverage for student dependents

Dependents studying full-time outside the province or country, but within North America, are covered for emergency claims where they are studying, but only if they return home
every 60 days. For this reason, you might want to consider buying a longer-term medical plan usually available from the educational institution.

Travel coverage ends

Your coverage ends automatically when you begin your IBEW Local 353 pension,
or reach age 70, whichever comes first. Coverage for your spouse and children ends
when your coverage ends (or sooner if they no longer qualify).

Vision care & Hearing aids

Vision care

Eye exams are covered to $125 every 24 months from the date of your last eye exam.
You are also covered for the following services and supplies up to a combined limit of
$450 every 24 months starting from the date of your first purchase. You must have a
written prescription by an ophthalmologist or optometrist in all cases.
Eligible expenses include:
• Eye pressure monitor
• Glasses, contact lenses, prescription sunglasses and safety glasses
• Laser eye surgery
• Visual training and therapy to improve faulty visual skills
• Contact lenses for special medical conditions (separate limit up to $450 per lifetime).
Please call Great-West Life for your current vision care balance and next eligibility date.

Hearing aid

The plan pays the cost of hearing aids including repairs to a maximum of $500 in any 60-month period. Before you make a purchase, contact the Ontario Assistive Devices Program, which may pay as much as 75% or $500 toward the cost of the hearing aid.
To learn more about Ontario Assistive Devices Program, visit www.health.gov.on.ca
or call 416-327-8804.

Treatments	Coverage
Diagnostic services including: Examinations and x-rays	100%
Preventive services including: Cleaning, polishing, fluoride treatment, oral hygiene instruction, root planin	100%
Restorative and surgical services (minor) including: Fillings (amalgam and tooth – coloured), stainless steel crowns, extractions and other basic oral surgery	100%
Restorative services (major) including: Inlays, onlays and crowns	50%
Endodontic services including: Root canals, removal of tooth nerve	100%
Periodontic services including: Periodontal surgery and bite adjustment	75%
Removable prosthodontics including: New dentures, denture repair, relining, rebasing and replacemen	100%
Fixed prosthodontics including: New bridges, bridge repair and replacement	50%
Orthodontic treatment for children ages 6-18 when treatment begins: Lifetime maximum of $2,000 per child	75%